To Örebro University

Objective: The aim of this study was to compare the use and short-term outcome of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Sweden, Norway, and the Netherlands.

Background: Although bariatric surgery is performed in high volumes worldwide, no consensus exists regarding the choice of bariatric procedure for specific groups of patients.

Methods: Data from 3 national registries for bariatric surgery were used. Patient selection, perioperative data (severe complications, mortality, and rate of readmissions within 30 days), and 1-year results (follow-up rate and weight loss) were studied.

Results: A total of 47,101 primary operations were registered, 33,029 (70.1%) RYGB and 14,072 (29.9%) SG. Patients receiving RYGB met international guidelines for having bariatric surgery more often than those receiving SG (91.9% vs 83,0%, P< 0.001). The 2 procedures did not differ in the rate of severe complications (2.6% vs 2.4%, P= 0.382), nor 30-day mortality (0.04% vs 0.03%, P= 0.821). Readmission rates were higher after RYGB (4.3% vs 3.4%, P< 0.001). One-year post surgery, less RYGB-patients were lost-to follow-up (12.1% vs 16.5%, P< 0.001) and RYGB resulted in a higher rate of patients with total weight loss of more than 20% (95.8% vs 84.6%, P< 0.001). While the weight-loss after RYGB was similar between hospitals, there was a great variation in weight loss after SG.

Conclusion: This study reflects the pragmatic use and short-term outcome of RYGB and SG in 3 countries in North-Western Europe. Both procedures were safe, with RYGB having higher weight loss and follow-up rates at the cost of a slightly higher 30-day readmission rate.